Provider Demographics
NPI:1174679898
Name:SHEA, PATRICIA WHEELER (APRN, BC)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:WHEELER
Last Name:SHEA
Suffix:
Gender:F
Credentials:APRN, BC
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:
Other - Last Name:WHEELER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN, BC
Mailing Address - Street 1:15 CLIFF ST
Mailing Address - Street 2:
Mailing Address - City:MARBLEHEAD
Mailing Address - State:MA
Mailing Address - Zip Code:01945-3005
Mailing Address - Country:US
Mailing Address - Phone:781-639-8595
Mailing Address - Fax:
Practice Address - Street 1:74 ATLANTIC AVE UNIT 201B
Practice Address - Street 2:
Practice Address - City:MARBLEHEAD
Practice Address - State:MA
Practice Address - Zip Code:01945-3067
Practice Address - Country:US
Practice Address - Phone:781-908-0730
Practice Address - Fax:949-798-3037
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA168529363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health